My 92 y/o Grandma is getting outpatient physical therapy. She surprised us by being capable of a lot more than what she thinks she's capable of. The problem is that while she does a lot with the therapist without complaint, things are another story at home. She whimpers/cries/moans when she has to do something as simple as get up and go to the bathroom at home. She makes noises the whole way to/from the bathroom and while she's in it. This is less than 15% of what her therapist makes her do and she doesn't behave like this with him. At home, she acts like she can't do anything like putting her feet in bed by herself. She keeps saying, "I can't", but she's perfectly capable of doing all these things. Then sometimes on the way back from the bathroom, she'll act like she's out of breath and says she needs to sit down - that she can't make it back to the living room. Yet, the therapist has her walking 5 times that distance without issues or complaints. I don't know what's going on here. I suspect Grandma is trying to manipulate me, but I'm not sure how to respond to her, especially when she's panicky. And to be honest, that whiny, whimpering, crying thing is really ticking me off. If she's looking for sympathy, she's not going to get it from me - not with that behavior and not after what I've seen her do with the physical therapist. Before she started physical therapy she was relatively fine. Now she's all moody. Before she said she wished she could get better, but today when it was bath time she got upset and she wished she weren't here (she meant alive). She whimpered and carried on through the whole bath, but at least she didn't complain about being cold (that's a first). I don't know what to do with her anymore. I also don't know what to make of her behavior. She didn't act like this before she came to live with me two years ago. She's getting worse. I don't know if this is related to the return of her blood clots (we're not sure when they developed), if she's developing dementia (or if she has it and it's worsening). I guess ultimately, it makes me feel bad, like things are my fault because she didn't act like this before she came to live with me. But then, I try to remember that she came to live with me a few months after Grandpa died and maybe she acts like this because she's free of him grumping at and berating her (she's free to do as she wants). Then I also remember that the year she spent in assisted living seemed to give her a sense of entitlement and laziness because they did everything for her. Any suggestions or insight on any of this?

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Grandma and Grandpa were living in their own place until he got sick. So they had no choice but to go into assisted living. They lived there for six months then Grandpa died. Grandma continued to live there for about six months until she came to live with me. She's been with me about two years. I think from the time she moved in with me she's been pretending to be helpless because she wants to be catered to. I make her do as much as she can. But it was probably within the first 1-4 weeks of living with me that I first heard the whimpering/tearless crying. I don't know if the new doctor had already taken her off Warfarin (after reviewing her medical records). He didn't want her on it if there was no reason to be, and according to her records, there wasn't a reason to be on it long term.

I would say that six months after this, Grandma's feet, ankles, and calves started swelling. The doctor couldn't find a cause and Grandma denied having pain. There was one night she acted bizarre (hyper and crazy - mumbling to herself) but I attributed it to her sneaking and eating too much candy. I later wondered if she had a mini stroke.

Through 2017, the whimpering/tearless crying worsened, but no one knew why. In early 2018, I heard her say her legs hurt and I kept asking her about it. After she said it was her calves, I made and appt. and the clots were found via an ultrasound. She did not have any chest x-rays or ultrasounds. She's been on Xarelto since then.

By the time the clots were found, Grandma had become incapable of getting her pants on by herself. So the doctor said physical therapy would be a good idea. However, a few days after starting Xarelto, the swelling went down and Grandma could put her pants on by herself.

The physical therapist was surprised at how much Grandma is capable of (as was I). She's actually in pretty good shape for her age. The thing that really holds her back is the fear of falling. I suspect Grandpa yelled at her everytime she fell because he couldn't pick her up and had to call an ambulance. So that probably did some damage to her confidence. She always thinks she can't do anything. Although, with Xarelto, falling would be bad if she started bleeding or hit her head. I'm not sure she's aware of that though.

She actually doesn't need help with anything at home like getting her feet in bed. She's very capable of that, especially since starting physical therapy. What she needs though is some leg and arm strengthening (for getting up) and some exercises to help with balance since that's where a lot of the fear is. Her physical therapist surprised me again by saying that she thinks Grandma should continue with therapy. Although, maybe just going once a week instead of twice.

Today, Grandma was giving me lots of attitude and whimpering. She made a huge fuss everytime I told her to go to the bathroom (the urologist has her going every two hours or so). She also said she didn't have to pee. To make a long story short, I am now concerned there is a bladder/kidney problem going on. If not that, then she made be dehydrated. Either way, she's got a doctor appt. Monday morning and I am keeping a close eye on the situation. I've had many pets with kidney issues so I'm well educated on it.

Bottom line is that now she doesn't want to leave her recliner. Everytime I make her get up, she starts whining, whimpering and tearless crying with the whole quivering bottom lip thing. The only affect that has on me is instaneous anger. I'm tempted to tell her that if she has enough energy to whimper and carry on like that when she says nothing is wrong, then we'll have to increase her physical therapy to three times a week and find chores for her to do around the house. Maybe that will shut her up.
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Elderly people often show their best face to doctors, therapists, and other people in general. It's the caregivers who get the "real" person.

Have you asked her why she does so well in physical therapy but has such difficulty at home? (Don't accuse her of anything, just point it out as if you're genuinely wondering).

If your grandmother has blood clots they can be very painful.
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A few more details would help us give more specific replies.

After she came to live with you, how soon before the helplessness started? What was the reason she came to live with you? How does assisted living fit into the timeline?

Why is she having therapy at this time?

How are her blood clots being treated?

I wonder if she could have a session or two of occupational therapy? The therapist could come to the home and instruct her on how to get her feet into bed, for example. They could help with whatever activities Gram is having trouble with at home. This may give Gram some confidence to do these things on her own. Maybe. An occupational therapist could also suggest household changes to aid Gram. Maybe a narrow bed railing would help her into and out of bed. Or perhaps a little bench could be placed where she might want to rest. Etc.

I doubt very much that anything that is going on is your fault. Gram is 92 years old. She has had a number of medical problems. She is worn out. Some days she wonders why she is still around; she feels ready to leave this life. I think some moaning and groaning is to be expected.

What do you and your grandmother do for fun?
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Is it possible to get inpatient physical therapy? When my mom had a knee replacement they said we could bring her home and have outpatient therapy. We looked at each other and said "no way, we want inpatient therapy!" We both knew that mom would not try if it was outpatient. She would just depend on us to do everything.
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